The International Journal of Stroke is the flagship publication of the World Stroke Organization.

Thursday, June 15, 2017

Dr. Evans Nyambega knows from his own experience the need for increased stroke awareness and prevention in Kenya.

Dr. Evans
Nyambega is a pharmacist by profession. He is a stroke survivor as well as a
founder member and chairman of the Stroke Association of Kenya. Dr Nyambega is a stroke advocate in Kenya and is passionate about stroke prevention and the plight of stroke
survivors and says, “I wouldn't wish stroke on my worst enemy"

Where were you when you had your
stroke?

It happened
while going to work in the morning

Could you access hospital?

Since I was
deep in the village, I couldn’t access hospital as the nearest health facility
is far away from my home and there was a challenge of transport. The people
around me could not comprehend what was happening to me because I was in a coma
for a long time and couldn’t talk. The medical facility was also ill equipped
so they were unable to immediately diagnose the problem so they could not offer
any stroke related first aid at all. The problem was detected after three days
after my situation worsened and I was transferred to Nairobi city for further
treatment. Indeed I am lucky to be alive.

What expectations did you have for
your treatment, rehabilitation, recovery?

I expected to
be attended to immediately and get well to continue with my normal activities.
This was not to be. Diagnosis alone took a very long time. I didn’t expect
treatment to be life long, as I have to take medicine on a daily basis.

With failed
expectations at treatment level I was forced to have rehabilitation at a prohibitive
cost. I am not able to continue with normal life as I am dependent on drugs, physiotherapy,
occupational therapy and assistance of caregivers who may not take care of me
as I expect because they also have their own responsibilities and also they may
not be well versed with care for this kind of condition. The life of a survivor
in Kenya is almost wholly dependent on ill prepared and ill trained caregivers

Recovery is
very slow. I expected to recover immediately and did not know what was ahead
for me; I never expected recovery to take this long. Due to slow recovery, I
lost my gainful employment because my employer could not understand my problem.
Employers are focused on productivity and my impaired movement and speech could
not guarantee this.

What was your experience of treatment
and/or rehabilitation?

The first
problem I encountered with stroke treatment was diagnosis which took too long.
The cost of treatment is also prohibitive as the drugs are very expensive and I
could not afford this, bearing in mind that I eventually became unemployed. I
had a problem in remembering things like the time to take drugs because I suffered
cognitive challenges (memory, judgment, self-criticism) so I needed a caregiver
permanently. A special diet is recommended and I was discouraged from eating
favourite foods like soda, red meat and a lot of others that are classified as
possible causes of NCDs. Impaired movement led to difficulty in accessing
treatment and rehabilitation. I lost gainful employment resulting to abject
poverty. This situation made treatment and rehabilitation inaccessible.

What has helped you in your recovery?

·Use
of recommended drugs

·Physiotherapy

·Occupational
therapy

·Healthy
eating

·Positive
attitude

·Taking
one day at a time and taking life as it comes

·Formal
and informal psychological education

What have been/are your fears?

The fears are
if at all I will one day manage to get my full function capacity and get to
provide for my family? My greatest fear is the occurrence of another
stroke and how to prevent this.

How did your family and friends feel
and respond?

The family did
not have much information on stroke at the time. Their expectation was that I
would be treated, and then catch up with life activities, they never
anticipated long term care and this caused a lot of economic and emotional
anxiety to people around me.

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